Monthly Archives: July 2019

Parasitic Diseases: Norwegian Scabies…a closer look…

Norwegian or Crusted Scabies is an extremely contagious hyperinfestation with Sarcoptes Scabiei.  It is frequently misdiagnosed as psoriasis or seborrheic dermatitis by medical personnel that are…unaware.  It is estimated that individuals with Norwegian Scabies have up to 4,000 mites per gram of skin…often infected with over a million mites.  This compares with more typical scabies… Read more »

Parasitic Diseases: Scabies

Sarcoptes scabieie is known as the “itch mite.”  It is an oval, flattened mite with dorsal spines.  On exposure the mite burrows into the skin and deposits eggs in the outer layers (stratum corneum).  It affects families and communities world wide, but is most commonly found in children, young adults and the elderly.  It is… Read more »

Pityriasis Rosea–It starts with a Herald Patch…

Pityriasis Rosea (PR) is an inflammatory eruption characterized by salmon-colored papules and macular lesions that are at first discrete but may become more confluent.  It begins with a single “herald” or “mother” patch that often is the largest lesion.  Subsequently the patient develops generalized plaques which are oval or circinate and covered with finely crinkled,… Read more »

Seborrheic Keratosis: Atypical Forms…

Atypical Seborrheic Keratosis (SK) are variations that may be seen that are “less obvious” and may be confused with other skin lesions.  The photograph above is concerning because it is jet black and very thick.  Such lesions warrant a biopsy to exclude the possibility of a malignancy, such as melanoma. In the photograph above you will note… Read more »

Seborrheic Keratosis: Barnacles of life…

Seborrheic Keratosis (Keratoses) are incredibly common.  They are harmless “warty” spots that appear during adult life and are a common sign of skin ageing.  Although they appear warty and are frequently mistaken as warts, they are not warts (warts are caused by papiloma viruses). They present as oval, slightly raised to thick tan or light-brown… Read more »

Auricular Pseudocyst: Treating with buttons

Auricular pseudocysts are uncommon, noninflammatory, fluctuant swellings of the ear which are believed to be caused by accumulation of glycosaminoglycans and subsequent ischemic necrosis of the cartilage, or from repeated minor trauma to the ear.  They are often a therapeutic challenge.  Many treatment options are available, including simple aspiration, plaster of paris casts, injectable agents… Read more »

Actinic Keratosis: Field Treatments—5-Fluorouracil, Imiquimod, Ingenol and Photodynamic Therapy (PDT)

Field treatments for actinic keratosis are very effective, however, they can be quite reactive so patients need to be aware of this.  For patients applying 5-Fluorouracil (Efudex) or Imiquimod (Aldara) the treatment cycle is usually 4 weeks.  There are variations in this, such as, 2 weeks on, 2 weeks off then 2 weeks on again.  Ingenol… Read more »

Actinic Keratosis: Treatment—Cryotherapy

There are many treatment options available and one of the most frequently used is cryotherapy.  Liquid nitrogen is extremely cold, between -346.0 F to -320.44 F, and when used as a spray produces a rapid freeze of tissue.  This concentrates the thermal injury directly to the outer layer of cells, the abnormal proliferative cells that… Read more »